1. Mr J. Tyler and Prof B Singh Medway Foundation Trust
2 WEEKS AFTER AN ARTHROSCOPIC SHOULDER PROCEDURE PATIENTS HAVE FORGOTTEN THEIR PRE-OPERATIVE SYMPTOMS.
Mr J. Tyler and Prof B Singh
Medway Foundation Trust

2. Declaration
This study made up part of an University of Brighton MSc project.
No industry funding.

3. Introduction
This study investigates whether arthroscopic shoulder surgery confounds memory of pre-operative symptoms.
It is accepted that patients forget their pre-operative symptoms once they undergo a surgical procedure. The authors wished to quantify this using an accepted and validated symptom scoring system.

4. DASH outcome measure
This is a widely used Patient reported outcome measure
It well-validated measure of upper limb symptom progression.
Upper limb surgery outcome can be evaluated by comparing pre- and post-operative DASH scores.

5. The hypothesis
If patients can remember their pre-operative symptoms after surgery then a ‘recall’ DASH score obtained after surgery would be similar to the DASH score obtained prior to surgery.

6. Methods
Prospective cohort of 25 patients undergoing arthroscopic shoulder surgery
DASH outcome measure obtained prior to surgery
DASH outcome measure obtained after surgery; patients asked to recall their pre-operative symptoms
DASH scores compared using intraclass correlation coefficient (ICC 2,1).
2 way random effects analysis of variance with 2 recorded measures

7. Results Procedure Number ASAD 7 ASAD + ACJ excision 4 SLAP repair
Rotator cuff repair 6
Arthroscopic arthrolysis
TOTAL 25

8. Statistics
2 patients incorrectly filled the pre-operative DASH questionnaire and were excluded
DASH outcome scores tested for normality.
Normally distributed
Paired T test performed to compare the means.
Similar means
SPSS
Normal Q-Q plots, histograms with a normal curve overlaid and a Shapiro-Wilk test

9. Correlations

10. Intraclass correlation coefficient

11. Discussion
There was a large discrepancy between the ICC obtained in previous validation experiments: 0.96(1) and the ICC obtained in our study: 0.55.
Pearson correlation obtained in the validation experiments: 0.96(1) were also vastly superior to our results: 0.55.

12. Conclusion
This study shows that an arthroscopic shoulder operation confounds patients’ memory of symptoms and confirms the need to score patients symptoms prior to a surgical procedure

13. Reference:
1. Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther Mar;14(2):128–46.